Voices at the Top

Michigan HIV News, Winter 2000 Issue

Who better to respond to the needs of women in Michigan than, well - women. Loretta Davis-Satterla recognized the feminine face of AIDS long before she was appointed as the first director of the Division of HIV/AIDS and STD (DHAS) a year ago July. Davis-Satterla was a long-standing member of the Michigan Women and AIDS committee and served as the chair for five years. Debra Szwejda, who took on the position of HAPIS manager in December, comes to HAPIS from the Michigan Department of Community Health/Bureau of Substance Abuse Services (now the Division of Substance Abuse Evaluation) with a broad knowledge of public substance abuse services.

The Michigan Women and AIDS Committee has always been a very grass-roots group of dedicated women and men in the Detroit area, who very early on recognized that women needed advocates to address their special needs. "Having worked with the Michigan Women and AIDS Committee for many years and seeing the faces change and the numbers of women grow and those faces become younger, it makes me keenly aware that we have a lot of work to do," said Davis-Satterla.

Those faces have also been, disproportionately, the faces of Black women. "Being an African American woman, I do understand how difficult it can be for women in our culture to be able to say, 'I am an IV drug user," or to have power in relationships to be able to do some of the things that it's going to take to remain safe." "And so that's always ever-present in my mind. How do we do this in such a way that women are really able to incorporate these messages into their lives and not base it on someone else's life who may have a lot of power, including income and credit cards and a place to go, and a support system that may not be there for African American women that are most at risk."

"Also, I think that I have had inroads into that community and with professionals who work with African Americans at risk and I intend to work with and use those as we move along and look at what we really need to do in terms of targeted prevention."

"So far the community planning process has been really good in identifying the local needs," said Davis-Satterla, who feels that this will continue to "tease out and work through" all of the underlying issues for women.

An emerging issue particularly for African American women is the risk of becoming infected from their male partners, who are having sex with other men. "Clearly the epi (data) show that this is a population that is ever growing in their risk of HIV," said Davis-Satterla.

The new HAPIS manager also acknowledged this factor for women surfacing risk in the Detroit area, through data collected by the MDCH surveillance section. "It's a newly identified issue," said Szwejda. "Women are getting infected and don't know why. We need to identify prevention strategies that will address this very specific behavior."

Historically, it is injection drug use and being the sexual partner of an injection drug user that have been the high risk behaviors for women. And Szwejda has a broad knowledge of the publicly funded substance abuse intervention network, "in particular women's specialty treatment," she said.

"We need to work more with IDUs and partners of IDUs, because that is the biggest risk factor for women. For two-thirds of HIV-infected women ages 30-49 whose risk is known, 59% are IDUs. For two-thirds of all infected women, injecting drug use played a role, with 47% reporting injecting drug use themselves and 19% reporting a sex partner who is an IDU."

There is another drug related risk for women, Szwejda pointed out. "There is a portion of women .....who are trading sex for drugs or money to buy drugs. Often that drug is crack cocaine."

"We need to continue to focus on providing effective prevention for these women," said Szwejda, "who can be commercial sex workers, drug users, or partners of drug users."

HAPIS has already made strides in making prevention counseling and testing more accessible to women in the Detroit area by providing services in community-based as well as field-based settings, because a lot of women can not access traditional health care facilities. "And prevention activities are provided there in alternative venues such as beauty parlors and public housing, and target commercial sex workers," she said.

There are still barriers to providing prevention for women, said Szwejda. "Poverty, domestic violence, accessibility because of child care and transportation."

Click the link here for an in-depth interview with Loretta Davis-Satterla on a variety of topics.  

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